An international health response is underway following a deadly outbreak of hantavirus aboard the MV Hondius, an expedition cruise ship traveling through the South Atlantic. At least three passengers have died, and several others have fallen ill, prompting a massive contact-tracing effort across multiple countries.
The situation has drawn specific concern toward the Andes virus, a rare strain of hantavirus capable of spreading through close human-to-human contact. Scott Pegan, a professor of biomedical sciences at the UC Riverside School of Medicine, noted that while most hantavirus cases stem from rodent exposure, the Andes strain is unique.
“Typically, hantavirus outbreaks are small, and human-to-human transmission does not readily occur,” Pegan stated. He explained that most infections happen through contact with rodent saliva, urine, or feces.
However, he highlighted that the Andes virus is “transmitted more readily from human to human than other hantaviruses,” specifically through the exchange of bodily fluids or respiratory droplets during close contact.
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Health officials are investigating how the virus entered the ship’s environment. Pegan pointed out that the confined nature of a cruise ship likely played a role in the spread.
“A confined space such as a cruise ship cabin—especially among family members—can present a higher risk of transmission from an infected individual,” he said.
Despite the fatalities, experts suggest the virus is not as contagious as other common illnesses. Pegan noted that while a person with COVID-19 might infect 15 to 20 others, those with the Andes virus typically infect fewer than one other person on average.
Symptoms of the virus usually begin one to eight weeks after exposure. Initial signs are often flu-like, including fever, muscle aches, and fatigue. However, four to ten days after these symptoms appear, the condition can escalate into hantavirus pulmonary syndrome (HPS), characterized by severe coughing and shortness of breath that can lead to respiratory failure. The fatality rate for HPS is roughly 40%.
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Currently, there is no approved vaccine or specific treatment for hantaviruses in the United States. Treatment is limited to supportive care, such as mechanical ventilation.
“The best way to protect against Andes virus and other hantaviruses is to limit exposure to rodents and to individuals exhibiting flu-like symptoms,” Pegan advised. He added that the outbreak serves as a reminder for the travel industry to take respiratory illnesses seriously and to avoid assuming a patient merely has a common cold or flu when more serious zoonotic diseases could be at play.
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